HIV-related stigma and discrimination

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HIV-related stigma and discrimination

HIV-related stigma and discrimination

What's the issue?

Stigma is a human rights infringement that is linked to poor physical and mental health outcomes. Stigma continues to be experienced across the globe and disproportionately affects the most vulnerable populations.

In the context of HIV, it is important to mitigate the effects of stigma and discrimination because they hamper efforts to prevent new HIV infections and engage people living with HIV in care and treatment.

While many individuals, organisations and governments have worked diligently to reduce HIV-related stigma and discrimination, such efforts are not implemented at a scale necessary to have a significant impact on HIV outcomes. Additionally, a large body of research has been conducted to conceptualise HIV stigma, but the sheer number and diversity of questions and scales used in stigma research has made it difficult to compare findings across contexts.

What have we found?

Reducing HIV-related stigma is critical to the success of prevention, care and treatment efforts, and successful interventions are available and ready to be scaled
Our systematic review of interventions showed that considerable progress has been made in the stigma-reduction field over the last decade. The number, geography and complexity of interventions have notably expanded. However, critical challenges and gaps do remain that are impeding the identification of effective stigma-reduction strategies.
A practical framework and validated measures of HIV-related stigma and discrimination are essential for national monitoring and research efforts
STRIVE’s Global HIV Stigma and Discrimination-reduction Framework conceptualises how stigma functions, how it can be measured and where to intervene. The Demographic Health Survey (DHS) and the World Health Organization’s Bio-Behavioral Surveillance Survey have now included key questions from this framework, with significant implications for research, programming and regulations.
Removing human rights barriers to HIV prevention, care and treatment services is critical and can have a positive impact on HIV-related health outcomes
Adoption of the Greater Involvement of People Living with HIV (GIPA) principle has meant further progress towards eliminating HIV related stigma (UN member states, 2001). UNAIDS recommends seven key programme areas to reduce stigma and discrimination and increase access to justice for people living with and affected by HIV.

What impact have we had?

In 2015, seven standardised measures of stigma were included in the standard questionnaire of the DHS that is currently implemented in 180 countries.

Since 2015, the UN has required all member countries to report annually on discriminatory attitudes towards people living with HIV as part of Global AIDS Monitoring for the United Nations Political Declaration on HIV and AIDS. The indicator is calculated using two of the new DHS measures on stigma.

Also since 2015, the US State Department has included an indicator on HIV-related stigma and discrimination in the Annual Human Rights Report. The indicator is calculated using two of the new DHS measures on stigma.

In 2016, ICRW and STRIVE received an invitation from the US President’s Advisory Council on HIV/AIDS (PACHA) to participate in a two-day meeting organised by the disparities committee. The stigma reduction framework was discussed as a foundation for PACHA recommendations to the US Secretary of Health and Human Services to influence national policy.